Journal of Urgent Care Medicine

A 67-Year-Old Male with Shoulder and Neck Pain

The patient is a 67-year-old man who presents with pain in his right shoulder and posterior right neck pain that he says radiates to his right arm. He reports that he first noted the pain “a few months ago” and is seeking care now because it has become more severe and “constant.” View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next …

Utility of POCUS in Skin and Soft Tissue Infection

Urgent message: Point-of-care ultrasound (POCUS), just starting to become more prevalent in the urgent care setting, facilitates improved diagnostic and interventional clinical decision-making by aiding the clinician in discerning between cellulitis, abscess, or both. Chelsea M. Burgin, MD FAAFP and Dustin S. Morrow, MD FACEP INTRODUCTION Each year in the United States around 14 million patient encounters present with skin and soft tissue infections (SSTIs). A detailed history and focused exam differentiate between cellulitis and/or …

A 20-Year-Old Female with an Array of Gastro Symptoms

The patient is a 20-year-old female who presents to urgent care with 2 days of nausea, vomiting, crampy abdominal pain, and inability to tolerate anything PO. Her personal medical history is remarkable for type I diabetes mellitus. View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

Evaluating a Child with Chest Trauma for Pneumothorax in the Urgent Care Setting

Urgent message: The differential diagnosis is broad for patients presenting with chest trauma. Bedside ultrasound can expedite critical diagnoses and intervention(s) when pneumothorax is in the differential. CASE PRESENTATION History A 12-year-old male rolled an all-terrain vehicle (ATV) in the woods, sustaining head, torso, and extremity injuries. He was helmeted, but lost consciousness for an uncertain amount of time. His father found him and provided initial care at home. Because of persistent headache and vomiting, …

The Effect—or Non-Effect—of Rapid Medical Evaluation Programs on Resident Education

Urgent message: With significant overlaps in clinical staff, patient population, and provider training between emergency medicine and urgent care, valuable insights relevant to urgent care can be gleaned from understanding the effect of incorporating provider-in-triage training into emergency medicine resident education. INTRODUCTION Crowding is a major barrier to timely and effective patient care in emergency departments. Crowding occurs when the demand for care exceeds the ability to supply it in an efficient fashion. This is …

The Time for Urgent Care Clinicians to Embrace Bedside Ultrasound is Here

Ultrasound captured me from the start. It happened during a night shift on my emergency medicine clerkship at Hurley Hospital in Flint, MI. I remember awkwardly picking up a phased array probe for the first time and the astonishment I felt when that beating heart appeared in black and white on the screen when I pressed the probe against the patient’s gel-laden chest. I had seen ultrasound images online before, but this was different. I …

Abstracts in Urgent Care – June 2020

CPR Guidelines During the COVID-19 Pandemic Characteristics of COVID-19 in the Pediatric Population A Clinical Decision Rule for Predicting True Penicillin Allergy The Role of Antibiotics in Community-Acquired Pneumonia POCUS Overview: A Primary Care Perspective POCUS in Skin and Soft Tissue Infections Prioritizing Protecting Healthcare Workers During Resuscitation of COVID-19 Patients Key Point: Priorities should be given to reducing provider exposure and lowering aerosolization risk while oxygenating/ventilating, and considering whether or not resuscitation is appropriate. …

A 28-Year-Old Male with a Persistent Dry Cough

A 28-year-old male presents with complaint of a dry cough “forever.” He admits to intermittent chest pain. Exam reveals decreased breath sounds on the right. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

A 24-Year-Old Female with a New, Unexplained ‘Rash’ on Her Leg

The patient is a 24-year-old woman who presents to urgent care with several linear lesions on her leg, accompanied by a burning skin sensation which developed days after starting a job as an outdoor bartender at a local beach resort. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A Pregnant Woman with Upper Right Quadrant Pain

Urgent message: The presentation of a pregnant woman to urgent care is often associated with consternation for both the patient and the provider. When a pregnant patient presents to urgent care with right upper quadrant pain, initial bedside ultrasound screening for gall bladder disease can facilitate initial interventions as well as expedite follow up care. CASE PRESENTATION History A 25-year-old nulliparous female 24 weeks pregnant presented to urgent care 4 hours after onset of nausea, …